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Under penalties of perjury, l hereby cerilb' that chiLS Sales Disclosure, to the best of ray lcnowledg
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/d comp2eoe nce with 1C b1.1 -5.5, "Rea! Property Saks Disdasure Act',
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1. Will this property be the buyers primary
r�• residence? Provide complete addre%sofprimary
residence, including county.
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2. Does the buyer have a homestead in Indiana to be
vat Lad (or this residence? If yes, provide
complete address of residence being vacated.
including county:
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Under penalties of perjury, 2 hereby cerl7ty that this Sales Distlosure, to the best of my knowledge and belief, is true, correct
and wmple[e as required by IaW', and is prepared in accordance with 1C 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". (Note:
Spouse informmtton, Sorial Security and Driver's In numbers are not necessary if no Homestead Deduction is
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3. Homestead
o r •nergy He2ti1g/Cooling Syswm
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5. Wind Power Device
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6. Hydroelectric Power Device
7. Geothermal Energy Heating/Cooling Device
9. is this property residential rental property'.
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9. Would you like to receive tax sotements for this
property via e-mail? (provide contact information
below. Please nee lnirMCtians far MDM irforma Bon.
,vot available in all counties)
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Under penalties of perjury, 2 hereby cerl7ty that this Sales Distlosure, to the best of my knowledge and belief, is true, correct
and wmple[e as required by IaW', and is prepared in accordance with 1C 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". (Note:
Spouse informmtton, Sorial Security and Driver's In numbers are not necessary if no Homestead Deduction is
Last S djii" 0fBeyw r Dnvrr',
Lkm ,1lD19thar Number
sigaaron ajPt7n7 /Sn�h
$jan arb INL/JDIMTl
Rtarrd 1r3alNama Of Saw Z/spmisa
LartSdiBirs dJBayrr 2/SBBwe Drlvria 5t9.1y CarrSJlgk O /Sen97 S!CUII -Y
riPmbrr Ureme/f0/D'Jnr Nan:bw
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